Dr. Walter Ray Petersen , MD
General Practice • Burley, ID
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Walter Petersen has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Walter Petersen, MD was a registered General Practice practicing in Burley, ID. Throughout an active medical career spanning 9 years, Dr. Petersen provided care at the practice location at 1344 HILAND AVE until profile deactivation on 2020-10-07.
Practice Location & Contact Primary Location
1344 Hiland Ave
Burley, ID 833181564
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Burley, ID
Practicing in Burley, ID (37 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice Associates & Co-Workers
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Specialist
Career & Practice History Timeline
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Record deactivated on October 07, 2020
NPI status registered as active in NPPES database
Registered at 1344 HILAND AVE, BURLEY, ID 833181564 (Tel: 2086781138)
Registered at 1344 HILAND AVE, BURLEY, ID 833181564 (Tel: 2086781138)
Recorded as WALTER PETERSEN, M.D.
General Practice (License #M2705 in ID)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1344 Hiland Ave
Burley, ID 833181564
Phone: 2086781138
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